1. Field of the Invention
This invention relates to methods and devices for diastema closure and/or papilla regeneration.
2. Description of the Related Art
Gaps or “diastemas” can be present between the teeth for a variety of reasons. These include genetic and ethnic trends where there is a tooth-jaw discrepancy wherein the teeth are too small for the jaws or jaws too large for the tooth size. It is also common for the gums to recede over time creating dark triangles or spaces referred to as gingival diastemas. In the modern era of cosmetically aware patients, dentists are often asked to close small and large diastemas. Patients also ask to treat the black triangle (loss or shrinkage of the interdental papilla) by restorative or microsurgical techniques.
It is common to treat the gapping by filling the space with a bonded porcelain veneer; fabricated in most instances in a dental laboratory and then later bonded to the affected teeth. It is also very common and more expedient to close the diastemas with direct filling materials, namely bonded composite resin. In the past, a flat plastic strip (such as a Mylar™ strip) was placed and often adapted to the tooth with an interdental wedge or elastic spacer. There have been problems with all previous techniques.
In previous clinician option 1, no matrix is used. In severe diastema cases, the clinician sometimes uses the papilla (gum triangle) itself as a gingival matrix. This resulted in a good esthetic space closure, but often a biologically horrific contour. A sharp 90° angle combined with a lumpy and porous surface creates a poor environment for soft-tissue health.
In previous clinician option 2, a matrix is used with an interdental wedge. The problems with traditional clear plastic strips are that they are flat and require wedging, do not conform to the tooth, and are nearly impossible to maintain deep in the sulcus. The result is often an esthetic compromise. Furthermore, holding all four ends of the plastic strips while simultaneously light-curing a composite filling is always a challenge.
In previous clinician option 3, a matrix is used without a wedge. This approach can yield the worst of both worlds, incomplete space closure and gingival overhang. The flat plastic strip will not allow the required bulbousness near the gum line to fill the gingival gapping. Because the stock (flat) plastic strip does adapt in a facial-palatal direction, it will not stay in the sulcus and therefore wanders away from intimate adaptation to the rounded root, leaving the shelf or “overhang” that creates poor gingival health and shredding of floss, odor and food impaction.
Thus, there is a need for improved methods and devices for diastema closure and/or papilla regeneration.